Chapter 21

Lecture
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 Paris Junior College

2402
Anatomy and Physiology II
Chapter 21
Susan Gossett
sgossett@parisjc.edu
Department of Biology
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 Hole’s Human Anatomy
and Physiology
Twelfth Edition

Shier  Butler  Lewis

Chapter
21
Water, Electrolyte, and
Acid-Base Balance

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 21.1: Introduction
• The term balance suggests a state of equilibrium
• For water and electrolytes that means equal amounts enter and
leave the body
• Mechanisms that replace lost water and electrolytes and
excrete excesses maintain this balance
• This results in stability of the body at all times
• Keep in mind water and electrolyte balance are interdependent

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 21.2: Distribution of Body Fluids
• Body fluids are not uniformly distributed
• They occupy compartments of different volumes that
contain varying compositions
• Water and electrolyte movement between these
compartments is regulated to stabilize their distribution and
the composition of body fluids

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 Fluid Compartments
• Of the 40 liters of water in the Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

body of an average adult, about

two-thirds is intracellular fluid and 40
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one-third is extracellular fluid 36
Extracellular
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• An average adult female is about 32
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fluid
(37%)
52% water by weight, and an 28
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average male about 63% water by 24

Liters
22

weight 20
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16
14
Intracellular
12 fluid
10 (63%)
8
6
4
2
0

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 Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

Total body water

Interstitial fluid
Plasma

Intracellular fluid Lymph

Membranes of
body cells (63%) Transcellular fluid

Extracellular fluid
(37%)

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 Body Fluid Composition
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• Extracellular fluids are generally Relative concentrations and ratios of ions in extracellular and intracellular fluids

similar in composition including 150

140
high concentrations of sodium, 130
Extracellular fluid

calcium, chloride and bicarbonate 120

Intracellular fluid

ions 110

100
• Intracellular fluids have high

Ion concentration (m Eq/L)

90
concentrations of potassium, 80

magnesium, phosphate, and sulfate 70

ions 60

50

40

30

20

10

0
Na+ K+ Ca+2 Mg+2 Cl− HCO3− PO4−3 SO4−2
Ratio 14:1 1:28 5:1 1:19 26:1 3:1 1:19 1:2
(Extracellular: intracellular) 8
 Movement of Fluid
Between Compartments
• Two major factors regulate the movement of water and
electrolytes from one fluid compartment to another
• Hydrostatic pressure Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

• Osmotic pressure Fluid leaves plasma

at arteriolar end of
Capillary wall
capillaries because
Plasma outward force of
hydrostatic pressure
predominates
Fluid returns to
plasma at venular
Interstitial fluid ends of capillaries
because inward force
Lymph of colloid osmotic
vessel pressure predominates
Hydrostatic pressure
Lymph within interstitial
Transcellular spaces forces fluid
fluid into lymph capillaries
Intracellular Interstitial fluid is
fluid in equilibrium with
Serous Cell
transcellular and
membrane membrane
intracellular fluids
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 21.3: Water Balance
• Water balance exists when water intake equals water output
• Homeostasis requires control of both water intake and water
output

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 Water Intake
• The volume of water gained each day varies among
individuals averaging about 2,500 milliliters daily for an
adult:
• 60% from drinking Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

• 30% from moist foods Average daily intake of water Average daily output of water
Water lost in sweat

• 10% as a bi-product of Water of

metobolism
(150 mL or 6%)
Water lost in feces
(250 mL or 10%) (150 mL or 6%)
oxidative metabolism of Water in
moist food
Water lost through
skin and lungs

nutrients called water of Total intake

(750 mL or 30%)
Total output
(700 mL or 28%)

(2,500 mL) (2,500 mL)

metabolism Water in Water lost in urine
beverages (1,500 mL or 60%)
(1,500 mL or 60%)

(a) (b)

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Regulation of Water Intake

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 Water Output
• Water normally enters the body only through the mouth, but
it can be lost by a variety of routes including:
• Urine (60% loss)
• Feces (6% loss)
• Sweat (sensible perspiration) (6% loss)
• Evaporation from the skin (insensible perspiration)
• The lungs during breathing
(Evaporation from the skin and the lungs is a 28% loss)

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Regulation of Water Output

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 21.4: Electrolyte Balance
• An electrolyte balance exists when the quantities of
electrolytes the body gains equals those lost
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Metabolic
Foods Fluids
reactions

Electrolyte intake

Electrolyte output

Perspiration Feces Urine

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 Electrolyte Intake
• The electrolytes of greatest importance to cellular functions
release sodium, potassium, calcium, magnesium, chloride,
sulfate, phosphate, bicarbonate, and hydrogen ions
• These ions are primarily obtained from foods, but some are
from water and other beverages

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 Regulation of Electrolyte Intake
• Ordinarily, a person obtains sufficient electrolytes by
responding to hunger and thirst
• A severe electrolyte deficiency may cause salt craving

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 Electrolyte Output
• The body loses some electrolytes by perspiring typically on
warmer days and during strenuous exercise
• Some are lost in the feces
• The greatest output is as a result of kidney function and
urine output

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 Regulation of Electrolyte Output
• The concentrations of positively charged ions, such as
sodium (Na+), potassium (K+) and calcium (Ca+2) are of
particular importance
• These ions are vital for nerve impulse conduction, muscle
fiber contraction, and maintenance of cell membrane
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permeability Potassium ion Calcium ion

concentration decreases
concentration increases

Parathyroid glands
Adrenal cortex is signaled are stimulated

Parathyroid hormone
is secreted
Aldosterone is secreted
Renal tubules conserve
Intestinal absorption
calcium and increase
of calcium increases
secretion of phosphate
Renal tubules
Activity of bone-resorbing
increase reabsorption of osteoclasts increases
sodium ions and increase
Increased phosphate
secretion of potassium ions excretion in urine

Addition of phosphate
Sodium ions are to bloodstream
conserved and potassium
ions are excreted Normal phosphate 19
Calcium ion concentration concentration is maintained
returns toward normal
21.1 Clinical Application

Water Balance Disorders

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21.2 Clinical Application

Sodium and Potassium Imbalances

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 21.5: Acid-Base Balance
• Electrolytes that ionize in water and release hydrogen ions
are acids
• Substances that combine with hydrogen ions are bases
• Acid-base balance entails regulation of the hydrogen ion
concentrations of body fluids
• This is important because slight changes in hydrogen ion
concentrations can alter the rates of enzyme-controlled
metabolic reactions, shift the distribution of other ions, or
modify hormone actions

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 Sources of Hydrogen Ions

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Aerobic Anaerobic Incomplete Oxidation of Hydrolysis of

respiration respiration oxidation of sulfur-containing phosphoproteins
of glucose of glucose fatty acids amino acids and nucleic acids

Carbonic Lactic Acidic ketone Sulfuric Phosphoric

acid acid bodies acid acid

H+
Internal environment

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 Strengths of Acids and Bases
• Acids:
• Strong acids ionize more completely and release more H+
• Weak acids ionize less completely and release fewer H+
• Bases:
• Strong bases ionize more completely and release more OH-
• Weak bases ionize less completely and release fewer OH-

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 Regulation of Hydrogen Ion
Concentration
• Either an acid shift or an alkaline (basic) shift in the body
fluids could threaten the internal environment
• Normal metabolic reactions generally produce more acid
than base
• The reactions include cellular metabolism of glucose, fatty
acids, and amino acids
• Maintenance of acid-base balance usually eliminates acids
in one of three ways:
• Acid-base buffer systems
• Respiratory excretion of carbon dioxide
• Renal excretion of hydrogen ions

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 Acid-Base Buffer Systems

• Bicarbonate buffer system

• The bicarbonate ion converts a strong acid to a weak acid
• Carbonic acid converts a strong base to a weak base
H+ + HCO3-  H2CO3  H+ + HCO3-

• Phosphate buffer system

• The monohydrogen phosphate ion converts a strong acid to a weak acid
• The dihydrogen phosphate ion converts a strong base to a weak base
H+ + HPO4-2  H2PO4-  H+ + HPO4-2

• Protein buffer system

• NH3+ group releases a hydrogen ion in the presence of excess base
• COO- group accepts a hydrogen ion in the presence of excess acid
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 Respiratory Secretion of Carbon Dioxide

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• The respiratory center in the

Cells increase production of CO2
brainstem helps regulate
hydrogen ion concentrations in
the body fluids by controlling CO2 reacts with H2O to produce H2CO3

the rate and depth of breathing

• If body cells increase their H2CO3 releases H+

production of CO2…
Respiratory center is stimulated

Rate and depth of breathing increase

More CO2 is eliminated through lungs 28

 Renal Secretion of Hydrogen Ions

• Nephrons help regulate the hydrogen ion concentration of

body fluids by excreting hydrogen ions in the urine
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High intake of proteins

Increased metabolism Increased concentration Concentration of H+

of amino acids of H+ in urine in body fluids returns
toward normal

Increased secretion
Increased formation
of H+ into fluid of
of sulfuric acid and
renal tubules
phosphoric acid

Increased concentration
of H+ in body fluids
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 Time Course of pH Regulation
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• Various regulators of
Bicarbonate
hydrogen ion buffer system

concentration operate at
different rates First line of defense
against pH shift
Chemical
buffer system
Phosphate
buffer system
• Acid-base (chemical)
buffers function rapidly Protein
buffer system
• Respiratory and renal
(physiological buffers) Respiratory
mechanism
mechanisms function Second line of
(CO2 excretion)
Physiological
more slowly defense against
pH shift buffers
Renal
mechanism
(H+ excretion)

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 21.6: Acid-Base Imbalances
• Chemical and physiological buffer systems ordinarily
maintain the hydrogen ion concentration of body fluids
within very narrow pH ranges
• Abnormal conditions may disturb the acid-base balance
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Acidosis Alkalosis

pH scale

6.8 7.0 7.35 7.45 7.8 8.0

Normal pH range

Survival range
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 Acidosis
• Acidosis results from the Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

accumulation of acids or loss of Accumulation

of acids
Loss of
bases

bases, both of which cause

abnormal increases in the Increased concentration of H+

hydrogen ion concentrations of

body fluids Acidosis pH drops

• Alkalosis results from a loss of pH scale

7.4
acids or an accumulation of pH rises Alkalosis

bases accompanied by a decrease

in hydrogen ion concentrations Decreased concentration of H+

Loss of Accumulation
acids of bases

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 Acidosis

• Two major types of acidosis are respiratory acidosis and

metabolic acidosis Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display.

Kidney failure Excessive production of acidic

to excrete acids ketones as in diabetes mellitus
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Decreased rate Obstruction of Decreased

and depth of air passages gas exchange Accumulation of nonrespiratory acids
breathing

Metabolic acidosis
Accumulation of CO2

Excessive loss of bases

Respiratory
acidosis

Prolonged diarrhea Prolonged vomiting

with loss of alkaline with loss of intestinal
intestinal secretions secretions 33
 Alkalosis
• Respiratory alkalosis develops as a result of hyperventilation
• Metabolic alkalosis results from a great loss of hydrogen ions
or from a gain in bases, both accompanied by a rise in the pH
of blood
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• Anxiety
• Fever Gastric Vomiting with loss
• Poisoning drainage of gastric secretions
• High altitude

Hyperventilation
Loss of acids

Excessive loss of CO2

Decrease in concentration of H2CO3 Net increase in alkaline substances

Decrease in concentration of H+

Metabolic alkalosis
Respiratory alkalosis
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 Important Points in Chapter 21:
Outcomes to be Assessed
21.1: Introduction
 Explain the balance concept.
 Explain the importance of water and electrolyte balance.
21.2: Distribution of Body Fluids
 Describe how body fluids are distributed in compartments.
 Explain how fluid composition varies among compartments and how
fluids move from one compartment to another.
21.3: Water Balance
 List the routes by which water enters and leaves the body.
 Explain the regulation of water input and water output.
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 Important Points in Chapter 21:
Outcomes to be Assessed
21.4: Electrolyte Balance
 List the routes by which electrolytes enter and leave the body.
 Explain the regulation of the input and the output of electrolytes.
21.5: Acid-Base Balance
 Explain acid-base balance.
 Identify how pH number describes the acidity and alkalinity of a body
fluid.
 List the major sources of hydrogen ions in the body.
 Distinguish between strong acids and weak acids.
 Explain how chemical buffer systems, the respiratory system, and the
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kidneys keep the pH of body fluids relatively constant.
 Important Points in Chapter 21:
Outcomes to be Assessed
21.6: Acid-Base Imbalances
 Describe the causes and consequences of increase or decrease in body
fluid pH.

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 Quiz 21
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